CPT 74230Radiology

X-ray xm swlng funcj c+

CPT 74230 covers an X-ray study that evaluates how well a patient can swallow by tracking contrast material (barium) as it moves through the throat and esophagus. This test helps diagnose swallowing disorders and identify anatomical abnormalities affecting the swallowing process.

Showing rates for

National Average

Base Medicare rate

$118.06

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.53

PE RVU (NF)

3.08

MP RVU

0.04

Total RVU

3.65

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Split bill with modifier 26 and TC when professional and technical components occur in different settings (radiologist reads remotely)
Impact: Ensures both entities receive appropriate payment; prevents $118.06 underpayment when components split between facilities
Document medical necessity clearly linking to dysphagia diagnosis codes (R13.10-R13.19) or aspiration risk to prevent denials
Impact: Medical necessity denials account for 30-40% of initial rejections; proper diagnosis coding prevents $118.06 write-off
Distinguish 74230 from 74210 (esophagram without swallow function assessment) in documentation to justify the higher-complexity code
Impact: Prevents downcoding from 74230 ($118.06) to 74210 (lower rate); preserves approximately $30-50 difference in reimbursement
Bill globally (without modifiers) when the same entity provides both technical and professional components
Impact: Captures full $118.06 Medicare allowable; modifier 26/TC splits reduce individual payments by 40-60%
Verify LCD/NCD requirements for videofluoroscopy swallow studies in your MAC jurisdiction before performing
Impact: Prevents complete denial; some MACs require specific diagnoses or prior conservative treatment documentation
Code speech pathology consultation separately (92610 or 92611) if distinct evaluation occurs beyond the radiologic procedure
Impact: Additional $50-150 revenue when appropriately documented as separate service with modifier 59 if necessary

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 74230?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 74230 in 2025?

The 2025 Medicare national average reimbursement for CPT 74230 is $118.06 for both facility and non-facility settings. This rate is based on 3.65 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 74230 and 74210?

CPT 74230 includes assessment of swallowing function with cineradiography and/or video recording, focusing on the dynamic process of swallowing. CPT 74210 is a standard esophagram that evaluates esophageal anatomy and motility but does not include the specialized functional swallowing assessment component that 74230 requires.

Can CPT 74230 be billed with a speech pathology swallow evaluation?

Yes, but documentation must clearly distinguish the services. CPT 74230 is the radiologic fluoroscopic procedure, while speech pathology codes (92610/92611/92612) represent the therapeutic swallow assessment. When both occur simultaneously, ensure documentation shows each provider's distinct role and consider modifier 59 if required by payer.

How many RVUs is CPT code 74230 worth?

CPT 74230 has a total of 3.65 RVUs in 2025, consisting of 0.53 work RVUs, 3.08 practice expense RVUs (both facility and non-facility), and 0.04 malpractice RVUs according to the CMS Physician Fee Schedule.

What diagnosis codes are typically used with CPT 74230?

Common diagnosis codes include R13.10 (dysphagia, unspecified), R13.11 (dysphagia, oral phase), R13.12 (dysphagia, oropharyngeal phase), R13.13 (dysphagia, pharyngeal phase), R13.14 (dysphagia, pharyngoesophageal phase), J69.0 (aspiration pneumonia), and I69.391 (dysphagia following cerebral infarction). Medical necessity must link the diagnosis to the clinical indication.

Do I need modifier 26 or TC for CPT 74230?

Use modifier 26 when billing only the professional component (physician interpretation). Use modifier TC when billing only the technical component (equipment, supplies, staff). If your facility provides both components, bill globally without any modifier to receive the full $118.06 Medicare allowable.

How often can CPT 74230 be billed for the same patient?

Medicare and most payers do not have a specific frequency limitation published for 74230, but medical necessity must be documented for each study. Repeat studies require documentation of clinical changes, new symptoms, post-treatment assessment, or other justification. Studies performed too frequently without clear rationale face high denial risk.